瘢痕子宫患者剖宫产术后产褥感染的危险因素分析

Analysis of Risk Factors for Postpartum Infection in Patients with Scarred Uterus after Cesarean Section

【目的】探讨瘢痕子宫患者剖宫产术后产褥感染的危险因素。【方法】回顾性分析2018年1月至2023年10月本院收治的80例瘢痕子宫患者的临床资料,所有患者均再次行剖宫产术,根据其术后是否发生产褥感染分为感染组(n=20)与未感染组(n=60)。比较两组一般资料、是否存在妊娠期生殖道感染、是否存在上呼吸道感染;采用多因素Logistic回归分析瘢痕子宫患者剖宫产术后产褥感染的危险因素。【结果】两组年龄、体重指数(BMI)、孕周、手术时间、是否贫血、是否存在前置胎盘、妊娠期高血压、高脂血症、是否存在上呼吸道感染占比及孕周比较,差异无统计学意义(P>0.05);感染组胎膜早破、产后出血、妊娠期糖尿病、妊娠期生殖道感染占比显著高于未感染组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示:胎膜早破、产后出血、妊娠期糖尿病、妊娠期生殖道感染是瘢痕子宫产妇剖宫产术后产褥感染的危险因素(均P<0.05)。【结论】瘢痕子宫患者再次剖宫产术后产褥感染受诸多因素影响,其中胎膜早破、产后出血、妊娠期糖尿病、妊娠期生殖道感染可预测该类患者剖宫产术后产褥感染,临床应予以密切关注。

【Objective】To explore the risk factors of postpartum infection in patients with scarred uterus after cesarean section.【Methods】A retrospective analysis was conducted on the clinical data of 80 patients with scarred uterus admitted to our hospital from January 2018 to October 2023.All patients underwent cesarean section again and were divided into an infected group(n=20)and an uninfected group(n=60)based on whether they developed postpartum infection.Two sets of general information were compared,including the presence of reproductive tract infections during pregnancy and the presence of upper respiratory tract infections;Multiple logistic regression analysis was used to identify the risk factors for postpartum infection in patients with scarred uterus after cesarean section.【Results】There was no statistically significant difference in age,body mass index(BMI),gestational age,surgical time,anemia,presence of placenta previa,gestational hypertension,hyperlipidemia,proportion of upper respiratory tract infections,and gestational age between the two groups(P>0.05);The proportions of premature rupture of membranes,postpartum hemorrhage,diabetes in pregnancy,and reproductive tract infection in pregnancy in the infected group were significantly higher than those in the uninfected group(P<0.05).Multivariate logistic regression analysis showed that premature rupture of membranes,postpartum hemorrhage,pregnancy diabetes,pregnancy genital tract infection were the risk factors for puerperal infection after cesarean section in women with scar uterus(all P<0.05).【Conclusion】The puerperal infection of patients with scar uterus after cesarean section is affected by many factors,among which premature rupture of membranes,postpartum hemorrhage,pregnancy diabetes,pregnancy genital tract infection can predict the puerperal infection of such patients after cesarean section,which should be paid close attention to clinically.